The effect of music interventions in autism spectrum disorder: A systematic review and meta-analysis

Laura Navarro¹Nour El Zahraa Mallah²Wiktor Nowak²Jacobo Pardo- Seco¹Alberto Gómez-Carballa¹Sara Pischedda¹Federico Martinon-Torres²Antonio Salas^2*

• ¹Instituto de Investigacion Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
• ²University of Santiago de Compostela, Santiago de Compostela, Spain

Abstract Several disciplines have explored the relationship between autism spectrum disorder (ASD) and music, though most insights derive from cognitive sciences. This systematic review and meta-analysis synthesize evidence on the therapeutic effects of music-based interventions (MI) on communication, behavior, social engagement, attention, and quality of life in individuals with ASDautistic individuals. It also examines how participants perceive and process music, situating therapeutic findings within this perceptual framework. From a total of 346 publications screened in PubMed, Cochrane Library, and WILEY Online Library databases, 120 were included, of which 15 met the criteria for quantitative evaluation and meta-analysis, to assess the state-of-the-art of research on music and ASD autism in the fields of neuropsychology and cognitive sciences. The reviewed studies span a range of methodologies, including randomized controlled trials and qualitative research, and incorporate diverse MI strategies, such as active music-making, structured listening, and improvisational techniques. Despite methodological heterogeneity, the findings suggest a moderate overall beneficial effect of MI, particularly in enhancing social interaction (z = 1.89, P-value = 0.06), verbal communication— especially vowel articulation (z = 2.93, P-value = 0.01), behavior (z = 1.92, P-value = 0.06; after outlier removal), and quality of life (z = 1.67, P-value = 0.09). This study highlights music's potential as a non-invasive, engaging therapeutic medium that resonates emotionally, cognitively, and socially with individuals on the spectrum. Given evidence of context-sensitive and domain-specific strengths in musical abilities, music emerges as a promising therapeutic approach. Future studies should investigate individual variability in response to MI, aim to standardize outcome measures, and assess long-term effects. Such efforts will support more personalized, neurodiversity-affirming therapeutic models in ASD autism care.